Shahoumian Troy A, Phillips Barbara R, Backus Lisa I
Population Health Program, Palo Alto Veterans Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304. Email:
Population Health Program, Office of Public Health, Veterans Health Administration, Palo Alto, California. Dr Phillips recently retired.
Prev Chronic Dis. 2016 Mar 24;13:E41. doi: 10.5888/pcd13.150282.
Cigarette smoking increases the risk of illness and early death for people with coronary heart disease. In 2010, Brown estimated prevalence rates for smoking among veterans and nonveterans with or without coronary heart disease in the United States, based on the 2003 through 2007 data from the Behavioral Risk Factor Surveillance System (BRFSS). Recent changes in BRFSS methods promise more accurate estimates for veterans. To inform assessment of efforts to reduce smoking, we sought to provide prevalence rates for smoking behaviors among US veterans with coronary heart disease and to compare rates for veterans with those for civilians.
We conducted a cross-sectional analysis of participants who responded to BRFSS from 2009 to 2012. Accounting for complex BRFSS sampling, we estimated national prevalence rates by sex for smoking status, frequency, and quit attempts; for those with and those without coronary heart disease; for civilians; for veterans and active duty personnel combined; and, after adjusting for BRFSS mingling of active duty personnel and veterans, for veterans only. We examined differences between veterans and civilians by using age-standardized national estimates.
Among men with coronary heart disease, more veterans than civilians smoked and more were daily smokers, but veterans were no more likely to attempt to quit. Among women with coronary heart disease, we found no differences between civilians and veterans.
Cigarette smoking is more prevalent among male veterans with coronary heart disease than among their civilian counterparts. Not distinguishing active duty personnel from veterans can materially affect prevalence estimates intended to apply solely to veterans.
吸烟会增加冠心病患者患病和过早死亡的风险。2010年,布朗根据行为危险因素监测系统(BRFSS)2003年至2007年的数据,估算了美国有或没有冠心病的退伍军人和非退伍军人的吸烟患病率。BRFSS方法的近期变化有望为退伍军人提供更准确的估计。为了为评估减少吸烟的努力提供信息,我们试图提供美国冠心病退伍军人吸烟行为的患病率,并比较退伍军人与平民的患病率。
我们对2009年至2012年回复BRFSS的参与者进行了横断面分析。考虑到BRFSS复杂的抽样方法,我们按性别估算了吸烟状况、吸烟频率和戒烟尝试的全国患病率;针对有和没有冠心病的人群;针对平民;针对退伍军人和现役人员合并群体;以及在调整了现役人员和退伍军人在BRFSS中的混合情况后,仅针对退伍军人。我们使用年龄标准化的全国估计数来检验退伍军人和平民之间的差异。
在患有冠心病的男性中,吸烟的退伍军人比平民更多,每日吸烟者也更多,但退伍军人尝试戒烟的可能性并不更高。在患有冠心病的女性中,我们未发现平民和退伍军人之间存在差异。
患有冠心病的男性退伍军人吸烟率高于其平民 counterparts。不区分现役人员和退伍军人会严重影响仅适用于退伍军人的患病率估计。